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Form #718Consent of Parent
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Consent of Parent - Surgery of Minor (free form to use)
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CONSENT OF
PARENT
SURGERY
FOR MINOR
CONSENT OF PARENT
I, _________________________________,
declare that:
1.        I am the _______________ (Father/Mother)
of _________________________, a minor, age __________ (___), born ____________ (Date),
and I have full custody and control of the minor.
Â
2. Â Â Â Â Â Â Â I hereby consent to a
surgical operation to be performed on the minor, on or about __________ (Date),
by __________________________________________ (Surgeon). The purpose
of the operation is as follows: _______________________.
3.        I hereby consent that
preceding, during, and following the operation, such Surgeon may perform any
other procedure deemed necessary or desirable in order to achieve the purposes
specified above or to correct any unhealthy condition the Surgeon may encounter
during the operation.
Â
4.        Realizing an operation
requires the participation of numerous technicians, assistants, nurses, and
other personnel, I hereby consent to such participation by all qualified
medical personnel working under the supervision of such Surgeon before, during,
and after the operation to be performed.
Â
5.        I hereby consent to the
administration of any anesthetic as may be deemed necessary by such Surgeon.
Â
6.        I have been fully informed
of the hazards and possible consequences of the operation as well as possible
alternative methods of treatment. I understand the
operation may not be successful and
that there is also a danger of the following unfavorable results:
_____________________________________________________.
_____________________________________Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â ___________________
Signature                                                                                                          Date
_____________________________________Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â ___________________
Witness                                                                                                            Date
CONSENT OF MINOR
I, ________________________________,
have read the above consent form signed by my __________ (Father/Mother),
and hereby join with __________ (Him/Her) in the consent. The
above-noted Paragraph 6 has been specifically pointed out to me, and I am aware
of the possible unfavorable consequences of the operation.
____________________________________Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â _________________
Signature of Minor                                                                                         Date
____________________________________Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â _________________
Witness                                                                                                            Date
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Submissions to this site, including any legal or business forms, posts, responses
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legal council before engaging in any action based upon content contained on this
site.
These downloadable forms are only for personal use. Retransmission, redistribution,
or any other commercial use is prohibited. This includes reposting forms from this
site to another site offering free legal or other document forms for download.
Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
a licensed attorney review any legal documents for which you are searching in order
to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
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Keywords: legal forms, family, parent, minor, surgery
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